Treatment

It is critical to find out whether secondary aplastic anemia is caused by a medication or exposure. In some cases, removing the exposure can lead to recovery.

Mild cases of aplastic anemia may be treated with supportive care, or may not need treatment. Blood and platelet transfusions will help correct the abnormal blood counts and relieve some symptoms in moderate cases.

Severe aplastic anemia, which causes a very low blood-cell count, is a life-threatening condition. Younger patients with a severe case of the disease will need a bone marrow transplant if a matching donor can be found. Older patients, or those who do not have a matched bone marrow donor, can be treated with medications that suppress the immune system. These medications include anti-thymocyte globulin (ATG), tacrolimus, or cyclosporine.

ATG consists of antibodies made in horses or rabbits against a type of white blood cell in humans called T cells. It is used to suppress the body's immune system. ATG allows the bone marrow to start generating blood cells again, because many causes of aplastic anemia are thought to be due to the body's own T-cells attacking the stem cells.

Other medications to suppress the immune system, such as cyclosporine, tacrolimus, and cyclophosphamide (Cytoxan) also may be used. Corticosteroids and androgens have been used as well.

Outlook (Prognosis)

The condition usually gets worse unless the cause is removed or the disease is treated.

Untreated severe aplastic anemia usually gets worse, eventually leading to death. Mild and moderate forms of the disease can be slower.

Bone marrow transplant has been successful in young patients. It has a long-term survival rate of approximately 80%. Older patients have a survival rate of 40 - 70% after a transplant.

Possible Complications

Bleeding in the brain

Death caused by bleeding, infections or other complications of a bone marrow transplant, rejection of a bone marrow graft, or severe reactions to ATG

Infection

When to Contact a Medical Professional

Call your health care provider if:

You have signs of infection, such as fever

You bleed for no reason

You are feeling extremely tired or short of breath with activity

Prevention

Secondary aplastic anemia may be an unavoidable consequence of treatments such as chemotherapy. Avoid toxins such as benzene and arsenic, if possible.